SAM'S CLUB OPTICAL (NPI# 1366543803) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366543803 |
| Entity Type | Organization |
| Organization Name | SAM'S CLUB OPTICAL |
| Other Organization Name | SAM'S CLUB OPTICAL 30-8219 |
| Practice Address |
1801 Windsor Square Dr Matthews NC 28105-4662 |
| Mailing Address |
702 Sw 8th Street Bentonville AR 72716-0235 |
| Practice Telephone | 7048476742 |
| Enumeration Date | 2006-09-26 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | LINDA M. EPPERSON (NPI COORDINATOR) |
| Authorized Official Telephone | 3167885580 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 156FX1800X |
Technician/Technologist Specialization: Optician |
Eye and Vision Services Providers | ||
| X | 332H00000X | Eyewear Supplier (Equipment, not the service) | Suppliers |
| Other Name | Type Code |
|---|---|
| Sam's Club Optical 30-8219 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881924413 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 4420 King Avenue East, Billings, MT 59101 | 2010-01-04 |
| 1457589111 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 450 Townsend Road, Cocoa, FL 32926 | 2009-07-01 |
| 1427286251 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 745 W El Camino Alto Drive, Springfield (s), MO 65810 | 2009-07-01 |
| 1093951956 | Sam's Club Optical | Technician/Technologist | 755 N. Hwy 27/441, Lady Lake (the Villages), FL 32159 | 2008-12-24 |
| 1619125903 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3247 23rd Avenue, Evans, CO 80620 | 2008-08-29 |
| 1720236011 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2000 Clements Bridge Rd Ste 116, Deptford, NJ 08096-2011 | 2008-08-29 |
| 1184886913 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 11278 South Jordan Gtwy, South Jordan, UT 84095 | 2008-07-02 |
| 1356516116 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 3839 Mundy Mill Road, Oakwood, GA 30566 | 2008-04-23 |
| 1104095801 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 7100 West Arroyo Crossing Pkwy, Las Vegas, NV 89113 | 2008-02-27 |
| 1114101193 | Sam's Club Optical | Eyewear Supplier (Equipment, not the service) | 2650 East Craig Road, North Las Vegas, NV 89030 | 2007-12-26 |
| Street Address |
1801 WINDSOR SQUARE DR |
| City | MATTHEWS |
| State | NC |
| Zip Code | 28105-4662 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962429134 | Sams East Inc | Durable Medical Equipment & Medical Supplies | 1801 Windsor Square Dr, Matthews, NC 28105-4662 | 2006-07-16 |
| 1265984355 | Simakumari Chhatrala | Pharmacist | 1801 Windsor Square Dr, Matthews, NC 28105-4662 | 2016-10-25 |
| 1245781772 | Justin Hamilton Rice | Pharmacist | 1801 Windsor Square Dr, Matthews, NC 28105-4662 | 2016-10-19 |
| 1649573551 | Queen City Eye Center, O.d., Pllc | Optometrist | 1801 Windsor Square Dr, Matthews, NC 28105-4662 | 2010-12-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750917407 | Lauren Deasy Blackshaw | Counselor | 1163 Sam Newell Rd, Matthews, NC 28105 | 2020-03-13 |
| 1912549643 | Monarch | Community/Behavioral Health | 10545 Paces Avenue 634, Matthews, NC 28105 | 2019-10-15 |
| 1326515768 | Holly Harvey Heddleson | Nurse Practitioner | 1450 Matthews Township Pkwy Ste 280, Matthews, NC 28105 | 2018-10-24 |
| 1396241030 | Erickson Health Medical Group of North Carolina, PC | Internal Medicine | 2030 Windsor Run Lane, Matthews, NC 28105 | 2018-04-02 |
| 1811406994 | Lice Clinics of America of The Carolinas | Technician, Other | 3042 Suite C Senna Dr, Matthews, NC 28105 | 2017-09-21 |
| 1376065003 | Carillon Assisted Living of Mint Hill, LLC | Custodial Care Facility | 5601 Margaret Wallace Road, Matthews, NC 28105 | 2017-07-14 |
| 1568906055 | London Young | Physical Therapy Assistant | 11100- 11189 Berkley Square Ln, Charlotte, NC 28105 | 2016-12-19 |
| 1003363128 | New Beginnings Community Counseling Center | Community/Behavioral Health | 5232 Maragaret Wallace Road, Matthews, NC 28105 | 2016-09-07 |
| 1275993149 | Kristi Dougan | Nurse Practitioner | 434 N Trade St Ste 104, Matthews, NC 28105 | 2016-03-04 |
| 1205219896 | Kalyani Vellanki Starr | Dentist | 1819 Matthews Township Pkwy Ste 200, Matthews, NC 28105 | 2015-07-01 |
| Find all providers in zip 28105 | ||||
| Taxonomy Code | 156FX1800X |
| Grouping | Eye and Vision Services Providers |
| Classification | Technician/Technologist |
| Specialization | Optician |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336667153 | Vivencio Crisostomo Austero Jr. | Technician/Technologist | 3800 Pleasant Plains Rd, Matthews, NC 28104-5958 | 2017-08-31 |
| 1306124292 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2225 Matthews Township Pkwy Ste A, Matthews, NC 28105-2680 | 2011-07-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669027603 | Sharna Michelle Jones | Technician/Technologist | 526 Queens Creek Rd, Hubert, NC 28539-4188 | 2019-08-06 |
| 1467006536 | Timothy Jerone Turner | Technician/Technologist | 5809 Hillcrest Cir, Indian Trail, NC 28079-8652 | 2019-07-28 |
| 1215491782 | National Vision Inc | Technician/Technologist | 5343 South Blvd, Charlotte, NC 28217-4117 | 2019-01-29 |
| 1619431723 | L & J Boyd Enterprises, LLC | Technician/Technologist | 390 Number Nine Road, Fairview, NC 28730 | 2019-01-23 |
| 1881167807 | National Vision Inc | Technician/Technologist | 4434 Fayetteville Rd Ste 11, Raleigh, NC 27603-3612 | 2019-01-03 |
| 1750857413 | National Vision Inc | Technician/Technologist | 1602 S Stratford Rd Ste 120, Winston Salem, NC 27103-2924 | 2018-10-22 |
| 1508331448 | National Vision Inc | Technician/Technologist | 1216 Bridford Pkwy Ste Qands, Greensboro, NC 27407-2696 | 2018-10-08 |
| 1962997627 | National Vision, Inc. | Technician/Technologist | 591 River Hwy Ste P, Mooresville, NC 28117-6979 | 2018-06-26 |
| 1811498793 | National Vision, Inc. | Technician/Technologist | 2117 N Main St, High Point, NC 27262-7700 | 2018-02-26 |
| 1487165833 | Curtis Markee Threatt | Technician/Technologist | 2700 Reynolda Rd Apt 1302, Winston Salem, NC 27106-3847 | 2017-10-12 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.